Ultrasound energy is currently being used and intensively investigated for recanalization of thrombotically occluded arteries. The ultrasonic energy is mainly applied either by a transcutaneous approach or by a percutaneous approach through a catheter with an external ultrasound transducer. Catheter-delivered transducer-tipped ultrasound thrombolysis is a new and innovative method. In this article we summarize the current available data on the use of this new type of catheter and discuss future directions and clinical applications.